PHARMACOLOGICAL AND NON-PHARMACOLOGICAL TECHNIQUES TO REDUCE PERIOPERATIVE BLOOD LOSS IN SPINE DEFORMITY SURGERY: FINDINGS OF A NARRATIVE REVIEW

Waleed Mohammad Awwad, Khalid Murrad, *Rohail Mumtaz and Sultan Ayoub Meo

ABSTRACT

Introduction: Due to the increased complexity of spinal procedures performed to correct the deformities, there is a likelihood of more blood loss with most spinal procedures, which leads surgeons to devise some strategies to reduce the blood loss. The evidence from various studies reveals that different pharmacological and non-pharmacological strategies could be used to reduce blood loss among these adolescent patients. We aimed to review and synthesize the available literature on various techniques to reduce blood loss among such patients. Methods: We carried out an electronic search in Google Scholar and PubMed. We considered a study eligible if it was an original research study, published in English from 2010 to 2020, and had provided information on the various techniques and strategies to reduce blood loss during and after spinal surgery. Results: This review provided novel insights into the efficacy and safety of various pharmacological and non-pharmacological techniques in reducing blood loss perioperatively. We found pharmacological methods such as PEAK Plasmablade, use of tranexamic acid regardless of its dosage and modes of administration, blood transfusion, and non-pharmacological techniques such as preservation of spinous process, having two surgeons performing the surgery instead of one, screening of anemia before surgery, and a technique known as minimally invasive scoliosis surgery can reduce the perioperative complications, mainly blood loss, among patients indicating posterior spinal fusion surgery due to idiopathic scoliosis among adolescents. Conclusion: The findings of the review reveal that there is the benefit of using both non-pharmacological and pharmacological techniques to reduce blood loss. A comprehensive strategy with an interdisciplinary and multi-pronged approach is required to reduce blood loss during and after the spinal surgeries performed for deformities among adolescents.

Keywords: Spinal surgery, deformity, strategies to reduce blood loss, Narrative review.